Tuesday 21 January 2020

The 11 Week Fetal Medicine Unit Appointment

Birmingham Women's Hospital Fetal Medicine Department

On Tuesday 21st January we made our way to the Women’s Hospital in Birmingham. We were meeting with the team at the Fetal Medicine Unit for the very first time. A place I didn’t even know existed until a week before at our dating scan, where a body of fluid of 4.7mm was found on our growing babies neck.

This appointment was for the purpose of a CVS, a invasive form of testing that would give us answers to any potential chromosome abnormalities that may be present in our unborn child.

It’s something I’ve been thinking about none stop, it’s taken over every waking moment of my day as I ponder possible outcomes for this pregnancy and our little baby. 

We arrived with about half an hour to spare, the Women’s Hospital is the biggest hospital I have ever been to, I thought finding where we were meant to be was going to be a mission in itself so insisted that before we sit down for drinks, we locate the Fetal Medicine Department. 

As it happens it was a lot easier to find than expected, thanks to helpful signage all along the corridors. The next prominent problem was that I didn’t need a wee, and being 11+2 the likelihood was that they would require me to have a full bladder to carry out the scan.

We settled in the hospital cafe, I nursed a hot chocolate and a bottle of water, all the while knowing that when that body of fluid hit my bladder I was going to know about it. Still on the run up to our appointment at 4pm, I still didn’t need to pee. Sitting in the waiting room at 4pm, I didn’t need to pee.

As my name was called, suddenly I needed to pee. In fact my bladder was now so full that I thought it might burst. A Dr named Leo walked us down the corridor to a room set up and ready to scan, he took my pregnancy notes and started to ask me questions. I explained what had happened at our previous scan and that we were here to hopefully get more answers.

I had prepared 16 of my own questions for this appointment, and some flew right off the tip of my tongue without even looking at the composition I had composed. 

Dr Leo explained that the fluid was on the babies neck under the skin, that it was not in the amniotic fluid collecting behind the babies neck. The gel was applied to my lower tummy and the Doppler pressed down firmly on my extremely full bladder (which was of course picked up on the screen), straight away a grainy image of our little nugget popped into view.

Disappointingly it was no where near as clear as the scan I had at our local hospital the week before. I wondered if it was due to my very full bladder. Dr Leo said the amount of fluid looked about the same, and over all apart from that our baby looked as expected for the gestation. 

Baby had done some growing in the 5 days since our dating scan, going from a CRL (crown rump length) of 39mm to 44.8mm. I took this as positive as baby flipped around in utereo unaware that we were all peeking in. 

It was nice to not hear the doom and gloom that I was expecting from this appointment, it was being judged firmly on it’s own merit. I found out that the placenta in this pregnancy is posterior, which was going to make a CVS tricky (especially in conjunction with my retroverted uterus).

I was told to go and empty my bladder to see if that altered the position of anything that would make it possible to perform the CVS safely. My gut feeling has come to pass, I knew ahead of time that the possibility of a CVS was slim. 

I returned feeling a lot lighter, and they had me sign the consent forms for the CVS procedure. A consultant named Tracey came in and re-scanned me, she was positive for the most part but did bring the word ‘termination’ to the table.

It wasn’t advice to act upon, it was looking ahead once we have firm results. She was giving me options. I asked if was I was allowed to fly as we have a trip to New York booked in February and I was advised that this would be fine. I should take low dose aspirin to keep my blood thin a week before the flight, and wear flight socks to keep the risk of clots to a minimum. 

Tracey’s examination was the confirmation that a CVS would not be taking place that day. I was booked in for another attempt on Monday 27th January, where I will be 12 weeks + 2 days. 

The positives of today’s appointment was that the heartbeat was good and there were no signs of Hydrops (Hydrops are swellings that occur within the baby, like in the stomach or limbs etc). 

I left with no more answers than I had came with, but I was reassured that baby was doing ok in there. I feel positive that all this may turn out ok, But I won’t know that until I have the tests that can give me answers.

I could feel tightenings in my lower tummy today, I’m certain that this is my tummy starting to stretch to accommodate our growing baby.

I don’t feel like I can tell anyone I’m pregnant, I can’t announce that I’m having a baby, I can’t even actually say I’m having a baby, because I might not. All this might end in tears, but it might all be ok. I hate all of this uncertainty, I just want to know that our babies going to be ok.

Unfortunately not even the doctors can tell me that, it’s all about taking one day at a time, one test at a time and hoping, hoping and hoping.

If on Monday I cannot have the CVS again, I have decided that I want to pay for the Harmony test, this is a none invasive test that takes my blood that has our babies DNA within it. They can test this and then give us a low or high risk for the 3 Trisomies. 

The Harmony test is not diagnostic like a CVS, but it might just give us some answers where currently there are none. I want some form of answers before we fly to New York, and if they can’t do the CVS the only other option is waiting until 16 weeks when they will perform an Amniocentesis (A needle into the amniotic sac). 

I can’t go 5/6 more weeks with no answers so the Harmony result would acts as a potential band aid in the mean time.

That brings me to the end of my latest update, I will be able to write again on Monday.....

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